@layout("/common/_container.html",{bg:"bg-white",js:["/assets/modular/system/refundcard/refundcard_refund.js"]}){
<form id="userForm" lay-filter="roleForm" class="layui-form model-form">
    <div class="layui-form-item">
        <label class="layui-form-label">商户<span style="color: red;">*</span></label>
        <div class="layui-input-block">
            <select name="shopId" lay-verify="required" id="shopData" lay-filter="shopData" lay-search>
                <option value="">请选择商户</option>
            </select>
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">商户号</label>
        <div class="layui-form-mid layui-word-aux" id="shopNo"></div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">商户地址</label>
        <div class="layui-form-mid layui-word-aux" id="shopAdr"></div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">手机</label>
        <div class="layui-form-mid layui-word-aux" id="phone"></div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">卡号</label>
        <div class="layui-form-mid layui-word-aux" id="card"></div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">应退押金(元)</label>
        <div class="layui-form-mid layui-word-aux" name="deposit" id="deposit"></div>
    </div>
    <div class="layui-form-item text-right">
        <button class="layui-btn layui-btn-primary" type="button" ew-event="closeDialog">取消</button>
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>提交退卡</button>
    </div>
</form>
@}
